Change in direct measures of physical performance among persons with Alzheimer's disease

Measures of physical performance were used in intact and community populations. We examined upper and lower extremity physical performance tests among people with Alzheimer's disease.

A total of 367 persons with probable Alzheimer's disease, recruited from an Alzheimer's disease diagnostic center, were given three tests of lower extremity function and two tests of upper extremity function at 6 month intervals for up to 4 years. Gender, race, age and Mini-Mental State Examination (MMSE) score at baseline were used to predict subsequent decline in composite scores of lower and upper extremity function.

At baseline, older age and lower MMSE scores were associated with lower scores on both lower and upper extremity function. Males performed better at baseline on lower extremity tests only. For each point higher on MMSE, a person declined 0.023 Standard Unit (SU) less per year (p = 0.0001) on lower extremity tests and declined 0.019 SU less per year (p < 0.0001) on upper extremity tests.

Physical performance was measured across a range of disease severities and declined over time. Lower cognitive score at baseline predicted faster decline in both lower and upper extremity function. Demographic heterogeneity in decline suggests other predictors may identify factors protective against physical decline.